PS-195 Sucrose Versus Breastfeeding For Venipuncture In Term Infants. A Randomised, Prospective, Controlled Study With Analysis Of The Specific Cortical Response

Abstract

Background and aims Sucrose and breast milk during painful procedures are reported to decrease pain behavioural expression in neonates. Recent data showed a persistent cortical pain response while using the sucrose during a painful procedure. To compare the efficacy of sucrose versus breast milk for specific-pain brain activity relief during a painful procedure in neonates. Methods Randomised, prospective, controlled study. Each term newborn was randomly assigned to sucrose or breastfeeding group at day 3 during a systematic venipuncture. Change in the total haemoglobin concentration in the controlateral somatosensory cortex (Near Infra-red Spectroscoy, NIRS) was assessed 10 seconds before and after the venipuncture. Neonatal Facial Coding System (NFCS) was assessed 2 min before and at the time of the venipuncture. Groups were compared using Wilcoxon test for the variations in NIRS and Chi-square test for the NFCS scores. Results 113 newborns were included (sucrose: 56, breastfeeding: 57) with a mean (sd) of 39.3 weeks (0.9) for gestational age and 3370 g (478) for birth weight. 103 were analysed for the NIRS (sucrose: 55, breastfeeding: 48). Median (quartiles) of total haemoglobin concentration change was -8.5 µmol/L (-34.5; 12.5) for sucrose group and 12.3 µmol/L (-23.4; 39.3) for breastfeeding group with no statistical difference (p = 0.06). NFCS scores were significantly different with 46.8% with a painful score in the breastfeeding versus 26.8% in the sucrose (p = 0.03). Conclusions No difference were found between sucrose and breastfeeding on specific-pain brain activity during a venipuncture in term newborns. A discordance was revealed between NFCS scores and NIRS analysis.